 Our first presenters are from Bangladesh. So I'm very pleased to be able to welcome Dr. Shah Ali Akbar Ashrafi, who is the Chief of the Health Information Unit for the Ministry of Health in Bangladesh, as well as Hanan Khan, my apologies, with his Bangladesh to share their work on the integrated surveillance platform and strengthening of the COVID-19 system in the country. So I believe it is over to Hanan to share his screen. So welcome to the session. Thanks, Rebecca. So Dr. Ashrafi, we'll start right now. Can you see my screen? Rebecca, can you see the screen? Yes. Okay. Thank you. Thank you for inviting me in this session. That is the National COVID-19 System of Bangladesh. That is the DHS to Surveillance Package and the Piyong. Next please. You know that Bangladesh is a small country, near about 147,000 plus square kilometer of area with 160 million population and mostly dense country in the world. And when the COVID-19 outbreak began in December 2019, health officials of Bangladesh and development partners are getting ready under the leadership of our Honorable Prime Minister and after the first COVID-19 case detected on March 8 in Bangladesh, Minister of Health and Family Welfare realized just that the need for an integrated COVID-19 system and accordingly his Bangladesh are stepped into for the assistance. And initially started as COVID-19 Surveillance System. The national COVID-19 system now serving as a core COVID-19 data platform for the COVID-19 related informations and playing a vital role in controlling the COVID-19 pandemic. Next please. Now the highlights of the integrated COVID-19 in system of Bangladesh. All the COVID-19 informations in one place including our vaccination program related to the COVID-19 ICU and the associate logistics. More than 6 million tests already done and counting and COVID-19 samples are collected and being entered in the system from the more than 1,000 public and private sample collection facilities and hospitals. Those are tested through 126 PCR test laboratories for 46 gene expert lab and 356 rapid antigen test facilities and data are entered into the system. The test results are notified to the suspects through SMS automatically from the surveillance system immediately after test done and a self-service report printing system is also available in our DGC SOE portal. And providing the COVID-19 certificates with secured electronic verification system that is the QR code and the test certificate validation are integrated and being widely used by the civil aviation authority, port and airlines and immigration authorities worldwide. The test results and certificates are providing within 48 hours for the outbound travelers. Epidemiological analysis, geodistribution and GIS are providing critical aid to the policy makers to make various decisions and feeding the national COVID-19 dashboard portal in the justice of Minister of Health and Family welfare and also to the Honorable Prime Minister, Sir Fish. Thanks. So please, Mr. Annan Khan, we continue. Thank you, Dr. Ashok. So here's the background. The COVID surveillance system of Bangladesh is based on the actual DHS to COVID-19 package, which is developed by University of Oslo. His Bangladesh customized it for Minister of Health and Family Welfare Bangladesh, the base of the national department by consultation with the national COVID-19 technical committee and the DHS experts. The first version was released in March 2020. Though deployed as a surveillance system, his Bangladesh were requested to help on various COVID-19 issues to support distance support system, public awareness, prevent forgery of testing, in testing, additional system components are built upon DHS-2, which is now being used as a core DHS core COVID-19 test. So this is not actually a whole DHS-2. We built up on many components on the DHS-2. So this system is continuously updated and supported by his Bangladesh team. At the beginning, these systems financed by his Bangladesh only, later from August 2020, was partly funded by himself. His Bangladesh is the key support and implementation team for national HMIS based on DHS-2. Few of them are among the largest implementation in the world. For example, our MNCS tracker now have more than 48 million entities. So some technical highlights. So the main components of the whole COVID-19 ecosystem is the COVID case-based surveillance system using DHS-2. This also includes the vaccination status, vaccine logistics, or BLMS. Initially, we started with the AstraZeneca, but later on, more vaccines are coming up in Bangladesh. So now it's total four vaccine types of vaccine are available. Already, we are asked to be ready for the four types of vaccination. COVID-19 hospital status including ICU and associated logistics. It's also included quarantine and isolation status. COVID-19 certification for outbound travelers with secured verification validation. Alternative reporting system with validation for port and immigration within near real-time reporting data backup system. This is due to if the DHS-2 is unavailable, then the immigration will not stop. So that's the idea. Even the DHS-2 system unavailable for a moment for an hour, half an hour. By this time, this data backup system actually pushing the same the report data to that system. So they're actually two parallel system. One is that is backing up the main DHS-2 component. So in next diagram, we will see that in the process flow. More than 1,020 sample collection facilities and the 528 test laboratories, not only from public means from the government is also from the private facilities and commercial facilities are also there. Though not all are entering in the DHS-2, few are entering in Excel, which later we import through the PHP system. So we make a generic API interface middleware, which is designed to facilitate integration of the different systems, apps, and pre-formatted Excel sheets. The test results are notified to the suspects through SMS automatically from our DHS-2 surveillance system. Immediately after the result is entered, a QR validation and validation system is integrated within the DHS-2 system for security validation and verification. A self-service reporting printing option also we provided through the OTP so that people can take their own report from anywhere they want. So that's actually reduced the load on the facility as well as as well as reduce the people's to come to the facility. So there will be to prevent the COVID transmission. Providing COVID certificates with security electronic verification, QR code make them acceptable locally and internationally by the airlines and immigration. So this is actually we in a communication with our Minister of Foreign Affairs to broadcast to the all over the all immigration and airlines. So this is actually the flow. So it's very complicated. So in the center, this is the DHS-2 system, which is our standard DHS-2 package, what we customize for the validation. But upon that, we build many systems. So that says that.NET system self-service reporting system, which is actually for the report distribution, the report verification QR, the sexual bi-directional means that from DHS-2, the data is sent to the QR, the generator QR and embedded in the DHS-2. And same as well as support for the reporting system and the immigration for the verification validation. And we have a backup system for near real time. So this now is set up and finished 15 minutes. They backed up the new addition or any update of the test result to that system to the SQL script. This is done automatically. Each 15 minutes, they are synchronizing this data, test data from that server. So anytime if the DHS-2 system is down, their system can back up the all external systems and the immigration and the force so that there will be no chaos. So to facilitate all those, we have a regular application, those actually initially play crucial role. When the pandemic started, there is a lot of enthusiastic app development. So we have near about 300, more than 300 Android, iOS, Windows app and the web's based self-service systems. There is for the screening app and there is few sample app is coming up. So we build a national Corona care gateway. So through that is data come through the middleware from the middleware go to the sample collection and this come to the main COVID-19 surveillance system. So there is private facilities. They are sending through the Excel-based system. So this actually compared to the PHP-based front of that, but this actually gradually reduced and we are gradually shifting to whole thing with the DHS. So on the right hand side, you see the public health, public hospital, private hospital and private laboratories, public laboratories all are reporting through the DHS-2 systems right now. So this actually the data feeding to the many subsystems or dashboard. So the most important is the honorable prime minister of dashboard. So that she is aware of what is happening in the COVID situation. Also the national COVID dashboard and real-time COVID dashboard in our DHS system. So what is the challenges? So there is a lot of challenges. First challenge is the moving target. The continuously changing of the environment is actually make a thing quite difficult for us. Some of the labs and hospital have difficult different types of systems and they don't want to use the new system. So that is also a problem. Almost every day there is a new air for the COVID. So we make a middleware. So who wants to send through theirs from their system? So we have the middleware application to integrate. So recently we have directly integrated the DHS-2 system with a few labs which have high volume of the lab tested. Due to the change in requirement, keeping historical data and metadata clean has become a very challenging for us. Identification of tracked entity is challenged as the government decide to use mobile number as one of the key identifiers. And one mobile can be used by family. So that's also a challenge. Visualization requests are not available on in DHS-2. So we make several portals to visualize the data as they want. So deciding on the attribute data element for analysis, this is also challenging because you are aware that attribute and multi data element for multiple stages is not yet possible. Tracker performance issue is the most challenging part for us. So we overcome the challenges by developing the API platform, National Corona Care Gateway, which actually make a middleware for every external application. For immunization should have, we actually have the data intake process right now. But in future, we'll do through the API when their site, the API will be available. Available will make the integration. Test certificate. So there is several counterfeit companies come up. So we have embedded the DJQR system, which is PHP based and the JavaScript embedded in the DHS-2 with the secured government from subdomains. So that has the authenticity of the validation of that specific site. So ensure system availability to the airlines and immigration. So that's, we already said that, that's who has a backup reporting system. So that if the DHS-2 unavailable for a few minutes, hours, then it's not appropriate. Yes. Yeah, thank you. So this is some example of the external visualization. And finally, the acknowledgement. The DHS-2 system performance is a more than 5.8 billion track tentative was a huge challenge. We are incredibly grateful to the University of Oslo team, especially Bob, Marcus, Juire, Sunbold, Luciano and others. This initiative was initially funded by HISP, but later on funded by UNICEF. So we are also grateful to them. Government of Bangladesh, especially data general health service officials, Minister of Health, Reserviced City and the telecommunication, the grammar form. We are also grateful to HISP team because they are giving support 24-7 because without that 24-7 support is become actually very challenging for us to support the government of Bangladesh. So thank you in time. Thanks. Thank you so much, Dr. Ashrafi and Hanan. We really appreciate you taking the time to share the complexity and just the impressive rollout, more than 6 million tests in this national architecture. So the next presentation, we have colleagues representing from Indonesia. So we have Taufiq, Sitombul, Saifira, Sausadilla and Lalo Lian. The floor is yours for your presentation on contact tracing. Welcome. Hi. Thank you, Rebecca. We are from Indonesia. We focus on contact tracing COVID-19 platform in Indonesia. So next, Lian. So the team of Indonesia, we contribute and have contribution for MOH, especially for Infection and Emerging Disease Unit and Data Information Center, WSO Indonesia and SS2 Indonesian team. We are many teams and me, Taufiq, Sitombul and Yornbra. Next. Okay. So platform for contact tracing COVID-19, we call it like Indonesian's local language, silacak, it's been tracking. And this is the SS2 platform. And this is to NY silacak. So that's why there has been three times changed by adjusting the SOP, especially from the minister regulation. And this is to include it to adding metadata and justify for that. This is to SS platform. So this is the Indonesian's implementations and national wide. So hosted and managed by MOH in Data Information Center and national and regional user. And we spare the contribution to national report contact tracing, especially for the MOH and national task force. Next. So what is the COVID-19? So SS2 is the main of a platform, especially for the COVID-19. We already built and a success to build because like the WhatsApp book. So you can see later the explanation what software to register new user and new stakeholders to use the SS2. So this is very important and we can discuss later. We contribute to national ID system integration. So that's why national ID just enter to the SS2 and get the attribute, many attributes for national ID system. And we reduce the cost of time of the data entry. So it's very important. So the second, we at the third point, we contribute to integration, the red line, contribute to cases system integration, because like the additional other resource, so that's why it's very important to integrate with the contact tracing. The fourth items, we built the applications focus on contact tracing, Indonesian language, especially and very, very small application and very easy to manage, especially in Indonesian context and local people and facility type user. And the five, we built the Android packets. We didn't use the SS2 packets, we built from the from the scratch using the, especially from the mobile technology and especially to reduce the confusing from the SS2 person and non-SS2 person at the facility and DSO or PSO level. In the last, we implement superset dashboard, especially to make a real-time data connectivity presenting. All application is connected with the SS2 system or dashboard. Here, we will share the information of the two cases, especially the WhatsApp book, because it's like self-registration. And the second, we contribute the knowledge implementation, especially to support the local user. The other application you can see and you can join to the next session, like a buzzer or another discussion. Next, yeah. So the implementation, we start from November and March 2021, because the group of users is very, very, very changed. And so that's why it's very implemented, it's very small. We have been the 10 provinces and now from April until the next, the total users is 28,000 and we build, we implement in 30 provinces. And we receive many additional users from police officer and military officer as the contact tracer. So next, we can continue for the next presentations. Next, yeah. So our friends from here, we will introduce and present about Knowledge Hub and Registration System. Over to you, Shevira. Okay. Thank you for Mr. Tauvik. Hello, everyone. My name is Shevira. So for the next, we're going to talking about the Knowledge Hub. So what is the Knowledge Hub? So this is how we manage the knowledge from central level and to end user. So Knowledge Hub is a connecting and sharing platform. This is sorry, sharing platform that is innovative and a great tool for collaboration. So the member join group for various reason and they can clearly define how they use them. Adjusting to the pandemic situation, it was complicated to mobilize through Indonesia by gathering user in particular place. Therefore, the transfer of knowledge is chosen by using the online method when the participant can be trained in real time without considering the location as long as they can access the internet. So this one, it is to solve the internet issue. We have to record the activity, create ebook, our guidance in PDF format, and provide the video tutorials so that the user will have a signal program can choose the media to study or repeat the materials. So next, we have Knowledge Hub users and Knowledge Hub products. For the Knowledge Hub user, for the national, we have from Ministry of Health and National Task Force. And for the regional and facility, we have district health office and public health office. So there and then local government, local security officer and facilities. So we have about the Knowledge Hub products about the portal FAQ and publication, training server and activity user from many groups. The digital learning material poses ubiquitous and robust nature. They potentially allow more efficient facilitation of knowledge transfer and other advantage compared to traditional face-to-face learning materials. Next. So what is lesson learned? We can, for the first, about the technical obstacle and management constraint. It's about the many incoming requests from user and constraint. So the second is about the user constraints that are often faced is about the need face response to face the user, repetition of the session because of new user and user paradigm. And the last is about the connection can run offline and online. So to solve the issue, we have a record activity, create creative e-book in PDF format so that the user will have a signal problem can choose the media study. The digital learning material poses ubiquitous and robust nature that potentially allow more efficient facilitation of knowledge transfer and other advantage compared to traditional face-to-face learning materials. So for the next slide, we'll be presented by my friend, Mr. Lalulian. Time is yours. Thank you. Thank you, Shapira. Okay. Hey, everyone. My name is Lalulian. So I will be sharing about one system we build, registration system. We call the AMICA. AMICA is a WhatsApp bot for the user registration. So the system makes it easy who wants to have the access for a DS2 as the one, the main platform for the copyright research. Sorry. The motivation is the assigned April 2021 by the chance the police, the entity didn't grow the user. User can request for HAPDES. We have the HAPDES to have the people have the user to create like a troubleshooting or create the account. Request can reach 4,300 and 950 for the user request for every day. So if we create the manually, it's so hard. So that's why we create the one simple product. We use the WhatsApp bot because in Indonesia, literally digital is still not very good. So we make use the WhatsApp bot because the easy for the people in Indonesia use the WhatsApp. So this is the process. The process that I will be explaining the first times our HAPDES can make the code, unique code based on user role and the group. So the invitation will be created by a system and we send to the new users and there will be there will be a registration use the invitation. So after that, after they following the direction based on SOP and based the system we create the manually, sorry, we create the base system, they can get the account two and three minutes after they followed the process. Okay. This is the, what's the look, our system, amika, separation. You can see in the ones is the how do we create the invitations, invitation and the second picture, you can see how the process, the one the process from the new user use the set registration and we have the dashboard, the dashboard, like the monitoring and so, how many users for every this, every provincial, we can look and pointing where the position. Okay. So the from the listener on we see because the problem in Indonesia still load for the digital iteration. So we find many new user can have the error waiting for the standard password and the error to share location use the WhatsApp. So for this, the problem we improve the system make like the notification if they get the wrong like the password or they not use our standard and we make the video guides step by step the progress for user. And the next step, we make the new separation but now we and the registration we use the webs. So that's for me. Thank you. So much. Thank you so much to the team for sharing using incredible innovations and particularly around being able to reach and expand on the support networks to users. I think that's just a really fascinating story for many of our implementers here. So our next presenter, I will invite please Dr. Talia Shagai, who's the EIS fellow from US CDC, who will give us a presentation on challenges implementing DHIS to for the COVID-19 response within the South Sudan context. So please welcome Talia. Hi, thank you very much. I'm Dr. Talia Shagai with the CDC and the United States and I'll be presenting on an evaluation of the implementation of a DHIS to COVID-19 module in South Sudan based on work with my co-authors from CDC and the South Sudan Ministry of Health listed here. South Sudan is a landlocked country in Eastern Africa. Its capital is Juba. It gained independence in 2011, making it the world's youngest country. Since independence, South Sudan has suffered protracted civil strife and humanitarian emergencies, including food insecurity, outbreaks and flooding. The Ministry of Health has very limited human and financial resources and primarily relies on NGOs and donors. The Emergency Operations Center was activated in March 2020 and the first COVID-19 case was identified in South Sudan on April 6, 2020. In between then and June 13 of this year, they've recorded close to 11,000 cases and 115 deaths with peaks in May to June of 2020 and January to March of 2021. This shows the structure of the high level COVID-19 response in South Sudan. I'm not showing this to walk through every piece, but to highlight how multi-layered it is. The response is based in the Public Health Emergency Operations Center in Juba, shown in the top three boxes are the several Ministry of Health committees coordinating the response, and the middle row shows the technical working groups in charge of aspects of the response from points of entry to case management to logistics. Shown below the technical working groups are partners that implement the response work. Reporting and decision-making is a comprehensive process. Each technical working group overseen by the Ministry of Health is comprised of different implementing partners, each on its own funding cycle with its own internal objectives and processes. The exact number of implementing partners is difficult to report because there is a lot of turnover. At the moment, there are at least 10 partners actively implementing COVID response in South Sudan. There are five sources that feed into the COVID-19 surveillance system. These include points of entry, testing people entering the country, a network of Sentinel site health clinics conducting testing, an alert hotline where symptomatic people can call in and have a rapid response team come to them for COVID testing, pre-travel testing for people leaving South Sudan and requiring negative COVID certificate for their destination, and a contact tracing system testing those with known exposures. For people meeting certain case criteria, a sample is collected and tested either at the National Laboratory in Juba, a mobile laboratory outside of Juba, or at a private lab. Any positive cases identified or managed at home or in a COVID-19 clinic based on symptom severity. Ideally, all positive cases should have their information passed to contact tracers will list it and test all close contacts creating a small feedback loop. Accord COVID-19 data is captured beginning with a case form and lab request form. These are filled out for anyone receiving a COVID test. These films are formed on paper and attached their sample and sent to the lab, who then prints and attaches the results to the case and lab request forms after testing. All data are sent on either on paper or via email to the emergency operations center where data management personnel enter into the main South Sudan case database, which is maintained in Excel. Data on positive cases are sent via email to case management and contact tracing teams who return patient outcome data to the public health emergency operations center either through email or a phone messaging system. South Sudan can then report total cases to the deaths and case curves. In March 2020, South Sudan received funding to implement a COVID-19 DHIS II module. The DHIS II already existed in the country as it was first developed for HIV surveillance. However, the HIV module is still under development and has not yet been implemented. DHIS II development for COVID-19 was undertaken with the immediate goal of improving the COVID-19 response, the higher quality and more accessible data, and with a longer-term goal of overhauling and unifying the health information system by completely transitioning to DHIS II. The DHIS II COVID-19 module is planned with separate forms for each group that will use a system, one for the alert hotline to screen people who potentially need to be tested, a case form and lab request form for all groups collecting COVID tests, a lab form for labs testing the samples and producing results, and a form for case management groups to report case outcomes, and finally a form for contact investigations starting from each case. Ideally, the system would be customized based on existing forms that reflect the current movement of data through the system. However, the flow shown here is highly simplified. Remember that because of how the response is structured, multiple independent implementing partners collect these data, and there are no standardized and universally accepted data collection forms or sets of variables. For example, patient outcome data is collected by two different implementing partners conducting home-based care for mild cases, and at least three different implementing partners running COVID-19 clinics for more serious cases. That's a total of at least five independent groups collecting patient outcome data. Each of those five partners has developed their own internal data forms with their own variables collected and their own data management system. There's also no mandated standardized or regular data reporting across a system or an easy centralized way to report data. After more than a year of development, DHIS-2 is still not in use for COVID-19 in South Sudan. While most of the necessary steps have been completed for each component of the DHIS-2 system, system training and rollout has not yet begun. Why has this process been so hard? While I've already hinted at some of the main barriers, I'm going to describe here important challenges that have slowed the implementation for DHIS-2. I'll also talk about major successes that have come out of the development process. We evaluated the development of COVID-19 DHIS-2 module in South Sudan through a series of key informant interviews to identify the most important barriers and successes. We interviewed 13 people within the Ministry of Health among implementing partners between October 2020 and March 2021. We then synthesized common themes to better understand the development process, starting with barriers to the rollout. The first challenge identified was inadequate funding and capacity. For example, there was no funding to hire in-country back-end developers or existing capacity to make modifications to the back end of DHIS-2 within South Sudan, and development was outsourced to part-time Tanzanian staff without firsthand knowledge of the system in South Sudan. This has led to major lives in implementing changes and difficulty communicating needs to developers who don't understand the first system in person. There's also only a single epidemiologist in South Sudan with data management training who has been hired to work on DHIS-2, which is insufficient to facilitate and manage the development process, and he also has no back-end training to be able to develop the system. This has meant that changes to the DHIS-2 back-end happen slowly with variable quality. To address these issues, there's been a push to train technical staff in South Sudan to manage the back-end, and the Tanzanian developers were brought to South Sudan for two months to work in country. The second challenge identified is limited buy-in and willingness to share data across the implementing partners. It's been a struggle to convince partners to share data when there is no precedent to do so. To switch from a data management system they already use and know, and to take time out of their already busy days to actively participate in the process, even getting responses to emails can be difficult. This is exacerbated by high partner turnover as garnering buy-in has to start from the beginning each time a new partner enters the space. Even when the Ministry of Health is ready to proceed, lack of partner participation has slowed things down. To help address this ministry has started implementing weekly group meetings with the data focal person from each technical working group to create accountability and space for regular communication. Third, as I mentioned, each implementing partner has their own non-standardized data system, even when partners are willing to transition to DHIS-2, data are often not interoperable or easy to share. For example, the three forms shown here all show different versions of the case investigation form that should be filled at time of testing, all asking different questions with different sets of variables. This has added a large complicated step for implementation process as the Ministry and partners had to agree on standardized forms and variables that all parties would use. It's been a long iterative collaborative process to arrive at standardized forms and variables. Finally, South Sudan has poor infrastructure, security, and resources outside of Juba. It's difficult to implement DHIS-2 when you can't tell how a state's current process operates and visiting rural locations is often difficult through the lack of roads, lockdowns, and security concerns. Even communicating virtually is hampered by unreliable internet and phone service. Additionally, resources are spread even more thinly outside Juba, and other priorities often take precedence over COVID surveillance. For example, addressing immediate flooding concerns, as shown in this photo here, or impending famine. This has led to the role of DHIS-2 being concentrated in Juba, although with COVID restrictions looser now, travel outside Juba has begun with the goal of expanding COVID-19 surveillance. Now I'll talk about some of the exciting successes that have come out of the implementation process as well. First is the creation of a Ministry of Health Data Management unit. This is the first time the Ministry of Health has had a dedicated data management unit and has created the infrastructure for more regular coordination of health data through a central system. The Ministry of Health has dedicated full-time personnel to data management. A couple of the key people are photographed below and is making a long-term commitment to building stronger central health information system. Second, the process of implementing DHIS-2 has forced the Ministry of Health and Partners to build up capacity. Training has begun so the Ministry of Health staff can maintain the back-end DHIS-2 system. The process of participating in a DHIS-2 development has led to improved data management capacity among implementing partners. And funding for DHIS-2 has supported monetization of data collection forms from paper to tablets, and funded personnel within the Ministry of Health for the data management unit. And third, this process has set an important precedent, that health data in South Sudan can be more centralized and standardized. The Ministry of Health has taken major steps in playing a more central role in collecting and coordinating national health data. Through this process, the Ministry has now taken steps to mandate standardized data, regular reporting, and reporting through a centralized system. Inclusions while the DHIS-2 COVID-19 module is a powerful system for surveillance data management, rapid implementation requires minimum prerequisites that South Sudan just did not have. These include in-country technical capacity for back-end development, stakeholder buy-in to use the system, a sufficient number of trained human resources. However, the process of implementing DHIS-2 has helped build capacity and data infrastructure in South Sudan. It is a worthwhile investment for improving public health surveillance, even in countries with these challenges. And update the current target rollout date for the DHIS-2 system in the country is July 1st, so just in a couple weeks. Thank you to all the support I received from the Ministry of Health and to all my co-authors. Thank you, Talia, for sharing this incredible story. I think it's so important for us to remember all of the enabling factors and environmental factors that enable the strengthening and the rollout of these electronic systems. And I think this story around South Sudan really helps to pinpoint those challenges, but also some of the gains that you were able to make in a more systemic way despite what was happening. So we were really quite on time, and we have some time for actually question and answer. If anybody would like, you can feel free to just add your questions into the chat. We have our presenters here. I will also take a quick look into the community of practice. So let's see. Also feel free to raise your hand if you have a question for any of the participants here today. So I might actually start, and since you're here, Talia, I had heard through our HIST network around some of the work that was going into the interoperability between the laboratory system and DHIS-2. And I think we've also reached sometimes the similar types of challenges in being able to resolve those sort of non-technical bottlenecks. And so I was just wondering, based on sort of the experience out of South Sudan, was there anything that you would believe is important for other countries with similar complex operating environments? Or if there were an alternative approach that might be able to strengthen a level of system use that's perhaps less complex? We do see many countries with COVID-19 vaccine delivery kind of struggling between how to roll out individual level trackers at scale versus kind of relying on some of those paper-based aggregate reporting that works well. So I didn't know if you had any reflections from your field experiences. I think just similar to what I already presented that when there were groups that really wanted to make this transition and they didn't have the capacity to do so, we also just didn't have enough people to support them. We had to be in a million places at once. There were a time of competing priorities and what really needed to happen is to have someone sit down with them, go through their system, and figure out what variables need to be switched, how to make the systems interoperable, what steps need to be taken. And we just didn't have enough time or people to do that thoroughly. And having more people on our team would have made that much easier. Yeah, thanks for reinforcing that point. I think we talk so much about interoperability and we have a session after this one actually today and also I believe tomorrow. And one of the things that we often run into is this sort of this kind of top-down standards-based approaches and sometimes we forget the very, very basic surround actually knowing what our data variables are and are they consistent across different systems and how do they map to another. So to me that's a really great reminder. Let's see. I don't know if we have Hanan still on the line. Hanan, are you still here? No, I think he actually probably had to move. I know this is in the middle of their transition time moving back from work. Are you still here Hanan? I see your name. Okay, perhaps not. You cannot unmute. Let's see. Now I can unmute. Thanks, Rebecca. I'm here. I realized I cut you a little bit short because I was worried about time but we actually ran out of a presenter. So I just wanted to ask if there was anything we felt that we rushed you through on your experiences in Bangladesh. Hello. Yes. So if there is no question for COVID related issues, we actually have you see our challenges, the moving target. The capacity is also one and the area where actually we're facing significant number of huge challenges. For example, when it comes to the DHS training requirement is very minimal because DHS too, all of the country, they know what is DHS. But the private facilities and the outside, the government facilities, the new user. So what we did, we make an online training for two hours in the night so that they can teach on the DHS too. But the problem is the system is very long. So initially, with the help of UNFPA and UNICEF, we recruited data entry operators for helping them and gradually take out from those data entry operators to handing over those systems to the government. But still, the government is struggling to recruit and to facing the data entry and the interpretation challenge. So there are actually several recruiting process. For example, the government doctor recruiting process actually bring forward and try to recruit a set of doctors in the field as well as who has the informatics background to place with us. So this is actually government try to minimize. And we also try to minimize the recruit through the donors. For example, the defeat, the UK aid, UNFPA, World Bank, ADB. So all our helps to recruit short term people so that we can intermediary help those people. But the system and we always have a problem to hand over the systems gradually. Also, the funding support for his also running out in June. So this is but the most difficult is the chance. So if there isn't chance, we need it tonight. So which is impossible. So they have to understand that this time and carefully check with the earlier data effect how we implement and how to affect the system. So we need to take this test is fast with our test environment. And this takes some time. So understanding those is very difficult, especially in the political and in the media, because there's anything wrong is going to the media. Okay, we not get report two hours delay, we have to waiting in the queue, etc. So we try to minimize in technically, for example, the report printing, we're not drinking a record printing for the facility, so they can report print anywhere they want. We ensure that their QR is embedded. So certificate value. So when we started by remotely printing, they're actually they come there. Some some people come up with the first certificates will change the name picture and everything. So put it in for their own. So we have to put the QR embed with the government, our government supplements so that every QR is verified from that. So that's how we try to mitigate. So it's not there is a thumb rule, how we mitigate that. So when the challenge came, you have to find a way out how to why you want to mitigate and how fast you want. That's my suggestion. And for the the the the last presenter, what the manpower human resource challenge, that is technical channels and non technical channels, non technical channels, there's some mitigation way. For example, in laboratory, we set them to record in the paper and send the paper to the letter on to the race to the system. But the sending the paper is sometimes very difficult, because lab doesn't want to send any anything outside, because if the people know, they have to go to the media. So this kind of issues. So technical and non technical both challenges are there. But human resource in the government sector is a really very, very challenging and very difficult. Thank you. We appreciate that. Extra, extra few words based on your many, many years supporting begladeshen in the field. I do have a question from Jim in the chat. I think this is directed to South Sudan, but the need for DHIs to back and development. So I think perhaps this was maybe just a clarification of what what type of support does it maybe the core functionality the the database itself, the middleware development, or is it simply configuring the DHIs to system? I'm not sure if Talia, if the question is clear, if you're able to speak to that or not. Yeah, I can tell that nobody on our team has capacity for back end development, because we use the word back end development when clearly there are many words for different pieces of this. But we mean just configuring the DHIs to system. So what would happen repeatedly is a system would get customized, we do a review of it, we come up with all of these things that we need to be adjusted or changed. And then the process to actually get those changes made would take a month, six weeks. And it just was too slow for things to happen in any kind of reasonable timeline. Very clear. So that makes makes a lot of sense. I'm sure that's a familiar challenge. Taufiq and our Indonesian colleagues, did you have any last words? And then we can close in two minutes and have a little transition time. But Taufiq, anything else to add before we close the session or Lalu? I have a question to Taufiq. Hi, Anand. Yes, Taufiq. So I want to add something about the implementation. We implement a new model of implementation, especially to engage technology and synchronize what MOS does, especially to real-time data and connect with new technology like database. Taufiq? Thank you. Anand, last word or? No. A question to Taufiq. Because the content tracing, how they implement in Indonesia, I see the WhatsApp integration. So how you work with the WhatsApp as a support system, for example, in our system, we use WhatsApp as a support platform. So we have a Facebook support platform for various, but for a specific COVID, we have WhatsApp support group for the supporting the all-user, end-user, field-user. So anything problem, they type in the WhatsApp and a specific person will attend it. But you're using WhatsApp, I see your presentation. So what actually, how you use that actually? So is there any technical integration from your side? You're just using simple. Yeah, we are using WhatsApp, but it's meant to support what the supervisor or MOH request from the facility and the SO. So this is why it's the automatic boot, if based on the request from facility end-users. And we have been integrated, we use the web API, especially connect with the API, what the function needs, especially if the registration system, we connect with the API for the user creations, user group and user roles, and user organization unit, for example. Okay, thanks. Yeah, thank you. Yeah. Well, a huge thanks to our presenters. I just find this work just so impressive. It takes many years to really stand up strong surveillance systems and seeing all of this local innovation to strengthen COVID-19. I am sure is going to translate into strengthening the overall integrated electronic systems and be able to really reach into more timely reporting and better data use and better coverage, even in complicated environments. So I thank you all to the presenters with this. We can close this particular session. I think the Zoom will stay open for the next session in line. But at this point, Max, I think we can stop the recording.